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Your 2019 Dental Insurance Guide

November 21, 2018

Dental insurance policy document

Dental insurance can be baffling if you don’t work with these policies on a daily basis. Luckily, your dentist and dental office team members do handle benefit plans every day, and they can help you make the most of your dental insurance coverage. In this blog, we’ll walk you through some of the many ways to make the most of your dental insurance coverage in 2019.

Schedule Your Six Month Dental Exams

The first step in maximizing your dental insurance for 2019 is to schedule two dental checkups and teeth cleanings for yourself and every member of your family. These visits will help you make the most of dental insurance coverage in two ways. First, most benefit plans offer 100% coverage for these visits, so you will likely spend very little out of pocket. Additionally, six month dental exams give your dentist the opportunity to examine your smile and diagnose oral health conditions in the earliest stages. This means you’re more likely to need a conservative dentistry solution that receives a larger percentage of insurance coverage.

Discuss Available Benefits

Don’t assume you have unlimited dental benefits. Talk to your dental office or your insurer about plan maximums. In most cases, your dental insurance provider will set caps on coverage for individual treatments and the entire plan year. An in-network dental office agrees to pricing for covered services that fall within your plan’s set maximum, but if you visit an out of network dentist, you may have to pay slightly more to make up the difference in your dental office’s pricing and your insurer’s set maximums. In addition to limitations on individual treatment coverage, most benefit plans also limit their total coverage for the entire plan year to just $1000 to $1500 per person. If you don’t know your plan’s maximum annual coverage, discuss the available benefits with your dentist before getting started on a costly dental treatment plan.

Plan for Advanced Treatments

Because of low annual plan maximums (that haven’t been increased since the 1960s in many cases), making the most of coverage for a more complex dentistry service can be a little tricky. Most dental offices are aware of these coverage maximums, and they are happy to partner with patients to plan out advanced treatments to make use of any available benefits. Services like orthodontics and dental implant tooth replacement have several treatment phases that can be billed for individually. This means your dentist may be able to split the coverage over two or more plan years. You can also work with your dentist to apply for coverage preapproval or preauthorization from your benefit provider.

Meet Dr. Stansbury

Your trusted Tyler dentist, Dennis E. Stansbury, DDS, offers a variety of dental care solutions at affordable prices, and he and his dental team are always happy to help patients better understand and maximize dental insurance coverage. If you have questions about your benefit plan or want to schedule an appointment with our dedicated dentistry team, please give us a call. We look forward to hearing from you!

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